Don't the elderly deserve relief too?

Joy Seligman spent her career as a registered nurse, committed to helping patients feel as comfortable as possible.

“I have always been interested in people being taken care of,” she says, sitting in a recliner in her room in the assisted living section of Aviva, a Campus for Senior Life, where she moved from independent living three years ago. “If they are in pain, I want them to get help.”

Now, at 94 and suffering from chronic pain from arthritis and the debilitating tremors of Parkinsons, Seligman is the one looking for compassionate care. But after a long wait for Florida’s legalization of medical marijuana — which has documented success as a palliative for both of her conditions — she is still without hope of relief.

This month, just days after Seligman’s 63-year-old son, Len, met with Aviva staff to provide documentation of his mother’s acceptance into the state registry, the facility issued a new policy stating it “does not support a client or resident’s right to use medical marijuana,” citing federal statutes that still consider marijuana illegal, as well their own “drug-free workplace policy.”

According to Teresa Martin, the administrator in charge of skilled nursing and assisted living, Seligman was the first Aviva resident to ask about medical marijuana, prompting the facility to scramble for advice from other organizations in the state, including the Florida Healthcare Association which advises member ALFs to “be cautious” on the issue.

The new policy was precipitously put in place for a number of reasons, Martin says, not least of which was the fear of losing, under the Trump administration’s tougher drug stance, the federal Medicare and Medicaid funding the facility receives. Other concerns included potential physical risks to residents, legal risks for the nursing staff and issues of storage and appropriate administration.

“We had to look at making a decision for our campus,” Martin said. “And we made the decision that we were not going to risk those gray areas of potentially putting residents and staff at risk and jeopardizing our funding.”

For Len Seligman, who guided his mother through the lengthy medical and paperwork process necessary to qualify for the registry and who became a certified caregiver himself to assist her, the decision has been a tremendous letdown. He and his mother have been discussing this avenue for relief of her pain for nearly six years.

“My sense is that though they would like to support her, they don’t want to step forward,” Len told me. “They are not aware of other ALFs in Florida doing it yet and nobody wants to be the first. Yet a lot of people with the greatest need are in these sorts of facilities.”

Marijuana is still banned by federal law, but has been approved for medical use in the District of Columbia and 29 states, including Florida, which passed a constitutional amendment establishing a medical marijuana program in 2016 on 71 percent ballot approval.

Nursing homes in several other states have devised ways to accommodate residents who qualify for medical marijuana; according to the Centers for Medicare and Medicaid Services, none have yet lost financing or been penalized for doing so. At least a dozen ALFs in the state of Washington have formed medical marijuana policies in response to demands from residents and have even posted a template policy online.

But most assisted living facilities, like Aviva’s, still do not sanction marijuana’s use. Others have resorted to a “don’t ask, don’t tell” policy that Joy Seligman wants no part of.

“I have always been very concerned that if I was going to try it, it needed to be open and above board, I would not do anything illegal,” she told me. “And apparently it’s going to be a fight. In fact, I don’t think I will have the opportunity to benefit from it at all.”

Instead, Aviva recommended the Seligmans investigate the possible use of marinol, a synthetic alternative to THC which has no documented effect on Parkinsons’ symptoms, and which was suggested by a psychiatrist who had not examined Joy Seligman. Len Seligman finds that a “highly unsatisfying solution, especially coming from someone who is not a Parkinsons’ expert.”

Jean Kramer, Aviva’s relatively new COO, says the organization will “keep looking at this issue and exploring further” but that at this time,“we’re not ready to move ahead.” Meanwhile, the Seligmans haven’t decided whether they will take the fight further.

“I would hope to work with management in partnership for the better welfare of the residents,” Len says, “but they haven’t shown me yet they are taking it seriously. Meanwhile, there are real people suffering unnecessarily. I know my mother is not the only case — but she’s the case that matters most to me.”

Joy Seligman estimates it will take “10 years and the Supreme Court” to force a decision, a timeline she believes will likely outrun her own. Still, in her heart and soul, she’s still a nurse, dedicated to patients’ welfare.

“I don’t have the energy, but if it isn’t pursued, it’s not going to happen,” she says. “So if I can do something for the future, for someone else, I’d be happy.”

But why shouldn’t she also have the hope of quieting her tremors enough to write her name again? Why is she not entitled to relief from her pain, which ranges “from about 3 to 7 on a scale of 10” every day? A neurologist, a qualified medical marijuana physician and her primary care doctor all believe she is.

When I ask if she is currently taking anything for relief, she nods and says, “I’m taking a medication now — but I’d love to get off of it.”

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